THE POST-OPERATIVE ANALGESIC EFFECTIVENESS OF A NEFOPAM AND FENTANYL MIXTURE IN PATIENTS UNDERGOING SPINAL FUSION SURGERY

Abstract

Objectives: To evaluate the intravenous patient-controlled analgesic (PCA) effects of a combination of fentanyl and nefopam in patients who underwent spinal fusion surgery. Methods: 60 patients, who underwent spinal fusion surgery at the Spine Surgery Department, Military Hospital 103, from April to November 2022, were divided randomly into two groups: The F group (30 patients received fentanyl via intravenous PCA) and the NF group (30 patients received fentanyl and nefopam mixture via intravenous PCA). Patients in both groups were evaluated and compared for the pain level through the VAS (Visual Analog Scale), the Actual/Demand ratio (A/D), and the amount of post-operative fentanyl consumption. Results: The average VAS score of the patients in both groups at rest was < 4 and ranged from 2.3 - 4.2 during movement. The mean VAS score during movement after the first 24-hour period of the NF group was significantly lower than that of the F group (p < 0.05). The A/D ratio of the two groups at studied time points was > 75%; in which, the A/D ratio of the NF group was statistically significantly higher than that of the F group (p < 0.05). The amount of post-operative fentanyl consumption via PCA in the NF group was 646.17 ± 99.23mcg, 14.79% lower than in the F group (758.33 ± 138.42mcg), with p < 0.05. Conclusion: Intravenous PCA with the mixture of nefopam and fentanyl and with fentanyl alone are effective methods of analgesia after spine fusion surgery. The combination use of nefopam and fentanyl in PCA provided a better analgesia effect than using fentanyl alone.